Abstract

Background: Complex soft tissue defects with exposed tendons and bones in the ankle area are common injuries, and the treatment to cover the defect is still challenging. The lateral malleolus flap is a fasciocutaneous flap based on the perforating branch of the peroneal artery, giving 2 to 3 branches to penetrate the skin flap and a descending branch in the deep layer of the ankle. This branch has anastomosis with the anterior malleolus branch of the anterior tibial artery and continues to the foot, creating an anastomotic arch in the tarsal sinus and an anastomotic arch on the dorsum of the foot. This is convenient for the use of the proximal pedicle flap, which is enough to cover defects in the ankle, heel, or distal pedicle to cover the dorsum of the foot. The purpose of this report is to evaluate the results of applying the lateral supramalleolar flap for soft-tissue coverage of foot and ankle defects at Quang Nam General Hospital.

Methods: Retrospective study on 27 patients who underwent surgery to cover soft tissue defects in the ankle area with a flap above the lateral malleolus at Quang Nam General Hospital in the period of 2022-2024. Patients were evaluated for early postoperative results and skin flaps after 3 months according to the criteria of Oberlin.C and Duparc.J.

Results: 27 patients with an average age of 29.2, the main cause of injury was traffic accidents. The average covered size was 24cm², the largest was 36cm². Postoperative results included 1 case of complete necrosis (3.7%), 2 cases of partial necrosis (7.4%). Results after 3 months according to Oberlin.C and Duparc.J were good 85.2%, average 11.1%, poor 3.7%.

Conclusion: The lateral malleolus flap is one of the options for treating soft tissue defects in the foot and ankle.